<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('App_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-app_id" data-rule="required" data-source="app/index" class="form-control selectpage" name="row[app_id]" type="text" value="{$row.app_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Day_register')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-day_register" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[day_register]" type="text" value="{$row.day_register}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Day_login')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-day_login" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[day_login]" type="text" value="{$row.day_login}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Days')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-days" class="form-control" name="row[days]" type="number" value="{$row.days|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-num" class="form-control" name="row[num]" type="number" value="{$row.num|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
